Arm Test May Gauge Women's Heart Risk

March 4, 2008 -- After menopause, a woman's heart risk rises. And an artery in her arm may reveal the extent of that risk.

So say Italian researchers who studied 2,264 postmenopausal women for nearly four years, on average.

The key idea behind the study is all about blood vessels' flexibility -- specifically, their ability to widen to accommodate blood flow. Atherosclerosis, the hardening of the arteries, hinders that process. Basically, the more flexible the blood vessels are, the better.

When the study started, the women were nearly 55 years old, on average, and had no history of heart disease. They got a heart checkup and an extra test: flow-mediated dilation of the brachial artery, a major artery in the arm.

Flow-mediated dilation shows how widely the brachial artery opens to let blood flow through after the arm is squeezed by a blood pressure cuff. The researchers used an ultrasound machine to measure flow-mediated dilation in the women's brachial artery.

During the follow-up period, three women died of heart-related causes, nine had heart attacks, 10 were hospitalized to get narrowed coronary arteries reopened with catheters or stents, 21 had clot-related strokes (ischemic strokes), and 47 had transient ischemic attacks (TIAs), which are sometimes called mini-strokes.

Those women had worse flow-mediated dilation in their brachial artery at the study's start.

Heart threats -- smoking, diabetes, high blood pressure, and high levels of total cholesterol -- were important predictors of heart risk. Flow-mediated dilation of the brachial artery predicted heart risk, above and beyond those factors.

But the researchers -- who included Rosario Rossi, MD, of the Institute of Cardiology at Italy's University of Modena -- aren't ready to recommend the brachial artery test for all postmenopausal women.

The test hasn't been standardized and is costly, and the study's results may not apply to all women. The study provides "biological insight rather than practical implications," Rossi's team writes in the March 11 edition of the Journal of the American College of Cardiology.